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Dramatic improvements in stroke care

Charleston Area Medical Center

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Need to reduce the impacts of strokes

Charleston Area Medical Center (CAMC) is the flagship facility for CAMC Health System, a three-hospital healthcare system with a total of 838 beds based in Charleston, West Virginia, USA — the state’s capital and largest city.

Strokes are one of the nation’s biggest healthcare issues. Every 40 seconds someone in the U.S. has a stroke, and every four minutes someone dies from a stroke. About 133,000 Americans die from strokes every year. Those who survive strokes are often at risk for serious lifelong disabilities.

West Virginians are particularly vulnerable to strokes. According to the American Heart Association and the American Stroke Association, nearly 69 percent of the state’s residents are overweight or obese, significantly higher than the national average. Partly as a result, nearly 4 percent of West Virginians have had a stroke -- a rate more than a third higher than the national average.

For those suffering from an ischemic stroke—a blockage to a vessel supplying blood to the brain—patients may be given a clot-dissolving medicine called tissue plasminogen activator, or tPA, although if it is not received within a few hours of the onset of a stroke, it will have little to no effect.

Given the issues specific to West Virginia and CAMC’s role in providing healthcare services in the state, a more aggressive approach to treating stroke patients was required.

DNV GL Healthcare became CAMC’s accrediting body in 2013. They switched from a longstanding accreditation relationship with a competitor, as the executive staff decided to explore other alternatives.

Less severe effects of stroke

After two separate surveys with DNV GL Healthcare on its delivery of services to stroke patients, CAMC was able to strengthen its program for stroke victims, including creating more timely interventions by its team of eight neurologists. It also hired an additional radiologist to more quickly interpret brain scans.

As a result, the number of ischemic stroke patients who received tPA within an hour of their stroke totaled 140 between April 2016 and April 2017 — compared to approximately 30 in the year prior to that period. Patients also swiftly received antithrombotics and anticoagulation therapy. After discharge, patients were prescribed cholesterol-reducing drugs and smoking cessation counseling if needed.

The hospital also created a telestroke program, guaranteeing patients immediate care from a neurologist even if they are not at the CAMC facility. Care is provided through a “robot” that the neurologist may control remotely to perform a full assessment of the patient.

As a result of these changes, in 2014, 2015 and 2016, CAMC received the highest level of the Stroke Quality Achievement Award from the American Stroke Association. In 2015, CAMC was the recipient of a Malcolm Baldrige National Quality Award.